Society first heard the term ADD in 1980; today it's ADHD. Read how our knowledge of attention deficit hyperactivity disorder has evolved.

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Attention deficit hyperactivity disorder (ADHD) was recognized and described long before it became known as ADD and eventually as ADHD. In 1902, an English pediatrician, Sir George Still, described a group of children who were disobedient, emotional, and uninhibited. He blamed these behaviors on biology, having discovered that some of the children had other family members with psychiatric disorders. Early theories were that these children were the victims of poor parenting, and more discipline was the best treatment. As our knowledge of ADHD has evolved, so have the name of this commonly diagnosed disorder and recommended treatments for it.

By the latter part of the 20th century, ADHD was recognized as a true mental disorder, but was thought to be due to brain damage. "In the 1960s and 70s, we probably only recognized the most serious cases of ADHD," says Scott J. Hunter, PhD, director of pediatric neuropsychology at the University of Chicago. "The condition was described as 'minimal brain dysfunction' or 'hyperkinetic reaction of childhood.'"

ADHD Timeline

Hunter says that it was the American Psychiatric Association that first named the disorder in 1980, based on the symptoms of inattention, and called it attention deficit disorder, or ADD. Later, it was renamed attention deficit hyperactivity disorder, or ADHD. “Finally it was realized that there were different types of ADHD and it was broken down into inattentive, hyperactive, and mixed types," he says.

A glimpse at the ADHD timeline:

Before 1900. Symptoms of ADHD are considered a moral problem of children or their parents and discipline or punishment is seen as the best treatment.

1902. Sir George Still describes ADHD as a behavioral disorder that may be inherited.

1919. After some survivors of the influenza pandemic develop encephalitis and show symptoms of ADHD, the condition is blamed on brain damage. ·

1937. Scientists first report that stimulants can control ADHD symptoms. ·

1940. Symptoms of ADHD continue to be blamed on “minimal brain damage.” ·

1955. Ritalin (methylphenidate), a stimulant, is approved by the FDA. ·

1968. A disorder similar to ADHD called “hyperkinetic reaction of childhood” appears in the Diagnostic and Statistical Manual of Mental Disorders for the first time. ·

1979. An article in the influential journal Science refers to "the hyperactive child syndrome." ·

1980. The third edition of the manual uses the name "attention deficit disorder" (ADD). ·

1996. The second drug to treat ADHD symptoms, Adderall (dextroamphetamine and amphetamine) is approved by the FDA. Many other drugs soon come on the market. ·

2003. FDA approves Strattera, the first non-stimulant drug for ADHD, and the first to be approved for use in adults. ·

2003. The CDC reports that approximately 4.4 million children – about 8 percent of all U.S. children aged 4 to 17 -- have been diagnosed with ADHD, and 2.5 million of them are taking medication for the disorder.

ADHD Today

"Today we know that younger children are more likely to show hyperactivity ADHD symptoms and older children or adults are more likely to have symptoms of inattention. For most people with ADHD, symptoms are mixed and they change over time," explains Hunter.

The three subtypes of ADHD recognized today are:

Predominantly hyperactive-impulsive

Predominantly inattentive

Combined hyperactive and inattentive (mixed type)

To be diagnosed as one of these ADHD types, children must have six or more symptoms that fall into that category type. Examples of hyperactive-impulsive symptoms include inability to sit still, constant talking, and constant interruptions. Symptoms of inattentive ADHD may include being easily distracted or bored, difficulty focusing, daydreaming, or being unable to follow directions.

As the symptoms of ADHD have been categorized, doctors and mental health professionals have created a checklist of symptoms that define ADHD and the subtypes of hyperactive-impulsive and inattentive ADHD.

ADHD is now one of the most common childhood disorders diagnosed and it is increasingly recognized as continuing into adulthood. The fifth edition of the DSM manual is due out in 2013. What we continue to learn about ADHD may change how we define this common condition even further.

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